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Comparison of visual outcomes, alignment accuracy, and surgical time between two methods of corneal marking for toric intraocular lens implantation

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Session Details

Session Title: Rotational Stability & Outcomes

Session Date/Time: Monday 24/09/2018 | 14:30-16:00

Paper Time: 14:58

Venue: Room A4

First Author: : W.Mayer GERMANY

Co Author(s): :    T. Kreutzer   M. Dirisamer   C. Kern   K. Kortuem   S. Priglinger   D. Kook     

Abstract Details


To compare the efficacy of a computer-assisted marker system for toric intraocular lenses (TIOL) with manual marking techniques.


University Eye Hospital, Ludwig-Maximilians-University, Munich, Germany.


This prospective study included patients having cataract surgery with implantation of a toric IOL (Torbi 709 M). Theywere randomly assigned to 1 of 2 groups based on the marking system used, manual or digital (Zeiss Callisto Eye). Patients were included if they had age-related cataract and a regular corneal astigmatism of 1.25 diopters (D) or higher. Visual and refractive outcomes as well as rotational stability were evaluated. Vector analysis was performed to evaluate total astigmatic changes.


The study comprised 57 eyes of 29 patients; 28 eyes in the manual group and 29 eyes in the digital group. The mean toric IOL misalignment was significantly lower in the digital group than in the manual group (P=0.026). The mean deviation from target induced astigmatism was significantly lower in the digital group (0.10+/-0.08D versus 0.22+/-0.14D; P=0.008). During surgery, mean toric IOL alignment time was significantly shorter in the digital group (37.2+/-11.9 seconds versus 59.4+/-15.3 seconds; P=0.003). The mean overall time required to perform the surgery was significantly shorter in the digital group (727.2+/-198.4 seconds versus 1110.0+/-382.2 seconds; P<0.001).


A digital tracking approach for toric IOL alignment was efficient and safe to improve refractive outcomes. Furthermore, image-guided surgery helped streamline the workflow in refractive cataract surgery.

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